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Effect of fluorescein angiography on renal functions in type 2 diabetes patients : a pilot study
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Effect of fluorescein angiography on renal functions in type 2 diabetes patients : a pilot study
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Journal Article
Effect of fluorescein angiography on renal functions in type 2 diabetes patients : a pilot study
2017
Overview
Fluorescein angiography (FA) is an important tool for the diagnosis and management
of diabetic retinopathy. However, the safety of fluorescein sodium on renal functions is not
fully understood. One hundred type 2 diabetes patients, within the Ophthalmology Outpatient
Clinic at Alexandria Main University Hospital, Egypt, were enrolled in this prospective observational
study to determine the safety of FA on renal function. Serum creatinine and cystatin C were
measured pre- and 2 days post-FA. Urinary neutrophil gelatinase-associated lipocalin (uNGAL)
was measured pre- and 4 hours post-FA. Renal injury was defined as a 25% increase in serum
creatinine, cystatin C, or uNGAL. The study included 71 females and 29 males, with a mean age
of 55.73 ± 7.29 years. Baseline serum cystatin C and uNGAL were 0.89 ± 0.34 mg/L and 21.7 ±
2.39 ng/mL, respectively. Serum cystatin C and uNGAL significantly increased after FA to 0.95 ±
0.36 and 27 ± 2.81, respectively (P <0.001). Eleven patients (11%) experienced more than a 25%
rise in serum cystatin C from baseline, whereas 40 patients (40%) experienced more than a 25%
increase in uNGAL levels after FA. However, the mean serum creatinine level did not change
significantly after FA (P = 0.061). Only one patient experienced more than a 25% rise in serum
creatinine from baseline. FA showed a significant increase in early sensitive acute kidney injury
biomarkers (as serum cystatin C and uNGAL) in substantial number of patients, suggesting but
still not proving, a potential harmful effect of FA on kidney functions. These findings were not
demonstrated using ordinary serum creatinine.
